oxymorphone
Oxymorphone is an opioid medication. It's used to treat severe pain not relieved by non-opioid medications. Oxymorphone comes as an immediate-release (IR) tablet that's taken by mouth, typically 4 to 6 hours. It also comes as an extended-release (ER) tablet that's usually taken every 12 hours. To lower the risk of opioid use disorder, the pain specialist will prescribe the lowest dose for the shortest duration of time needed to treat your symptoms. Side effects of this medication include nausea, sleepiness, and dizziness. Brand names Opana and Opana ER both have been discontinued.
What is Oxymorphone?
What is Oxymorphone used for?
Management of short-term pain (immediate-release tablet only) or long-term pain (extended-release tablet only) that isn't relieved by non-opioid pain medications alone
How Oxymorphone works
Oxymorphone is an opioid. It attaches to certain opioid receptors in your brain to lessen how much pain you feel.
Drug Facts
More on Oxymorphone essentials
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What are the risks and warnings for Oxymorphone?
Oxymorphone can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Potential for addiction and misuse
Risk factors: Personal or family history of alcohol or substance use disorder | Personal or family history of mental health problems
Oxymorphone is a controlled substance because it has a risk for misuse and addiction. To lower this risk, your pain specialist will prescribe you the lowest dose needed to manage your pain for the shortest period of time. Take the medication exactly as prescribed. Don't change how much or how often you take it without talking to your prescriber first.
Never break or crush oxymorphone ER because this medication has a special coating that allows it to be slowly released in your body. Damaging the coating will cause the body to absorb too much medication too quickly and put you at very high risk for serious and life-threatening side effects, such as dangerously slow breathing and trouble staying awake.
Because of the risk for misuse and addiction, oxymorphone is only available through a Risk Evaluation and Mitigation Strategy (REMS) program called the Opioid Analgesic REMS program. Your prescriber and pharmacy must register with the program, receive training on proper medication use, and discuss with you about how to take oxymorphone safely.
Dangerously slow breathing (respiratory depression)
Risk factors: Taking medications that can cause slow breathing | Drinking alcohol | Older age | Being frail | Medical conditions that cause breathing problems (e.g., COPD, asthma, head injury) | Taking too much oxymorphone
Oxymorphone can cause dangerously slow breathing, which can be life-threatening. This can happen to anyone and even at recommended doses. But the risk is greatest when you first start treatment or when your pain specialist raises your dose.
Your pain specialist will recommend that you have naloxone (Narcan) to carry with you at all times. Naloxone is a medication that can reverse slowed breathing from opioids. Use naloxone, call 911, and get medical help right away if you or your loved one notices that you have trouble breathing or have bluish-colored lips, fingers, or toes.
Risk for opioid overdose
Risk factors: History of opioid use disorder | Previous opioid overdose | Taking high doses of oxymorphone | Taking more opioids than prescribed | Alcohol use
Take oxymorphone exactly as prescribed. Taking too much medication or taking it more often than prescribed can lead to an overdose. It can be very dangerous if someone accidentally swallows the medication. Be sure to keep oxymorphone out of reach from children, pets, and visitors to prevent accidental exposure or overdose.
Symptoms of an opioid overdose include not responding to sound or touch, extremely slow breathing, slow heartbeat, extreme sleepiness, and cold or clammy skin. Be sure you and your loved ones know how to recognize an overdose. Your prescriber will recommend getting naloxone (Narcan) — either by prescription or over the counter. Naloxone can help treat an opioid overdose. Carry naloxone with you at all times; use it and call 911 right away if an overdose happens.
Difficulty concentrating and extreme sleepiness
Risk factors: Taking high doses of oxymorphone | Age 65 years or older | Drinking alcohol | Taking other medications that can cause sleepiness
Oxymorphone can cause extreme sleepiness and lower your ability to think, react, and focus. Don't drink alcohol with oxymorphone. Also don't take oxymorphone with other medications that can cause sleepiness or "brain fog" (e.g., benzodiazepines, muscle relaxants, sleep medications). Otherwise, these side effects might worsen.
Make sure you know how oxymorphone affects you before driving a car or doing activities that require your concentration. Talk to your prescriber right away if you feel too sleepy from the medication.
Serious interactions
Oxymorphone can have serious interactions with alcohol and several medications. For example, drinking alcohol while you're taking oxymorphone can put you at serious risk for drowsiness and confusion. Also, taking oxymorphone with medications that slow your body down (e.g., benzodiazepines, other opioids, muscle relaxants) can put you at risk for having dangerously slow breathing.
Let your care team know what medications you're taking to make sure they're safe for you to take together. Also speak with your care team first before making any changes to your medications because sudden dose adjustments can be harmful.
Harm to newborn babies
Long-term use of oxymorphone during pregnancy can cause your unborn baby to become dependent on the medication. This is because oxymorphone can pass through the placenta to your unborn baby.
Once your baby is born, they can experience withdrawal symptoms, such as high-pitched crying, poor feeding behavior, trembling, abnormal sleep patterns, and even seizures. This condition is called neonatal opioid withdrawal syndrome and can be life-threatening if not recognized and treated in time. Let your healthcare professional (HCP) know if you've taken oxymorphone during pregnancy or if you notice these symptoms in your baby.
Physical dependence and withdrawal
Risk factors: Long-term use of oxymorphone
If taken regularly for a long time, oxymorphone can cause physical dependence. This means that your body relies on the medication to function. And you might experience withdrawal if you lower your dose too quickly or suddenly stop taking the medication. Withdrawal symptoms include anxiety, restlessness, irritability, runny nose, yawning, sweating, and chills.
Don't suddenly lower your dose or stop taking oxymorphone suddenly without talking to your prescriber first. If you need to stop this medication, your prescriber will slowly lower your dose over time to prevent withdrawal symptoms. Talk to an HCP if you have concerns about taking oxymorphone because of the risk for withdrawal.
Serious allergic reaction
Some people have experienced serious allergic reactions after taking oxymorphone. Symptoms have included swelling of the face and tongue, hives, rash, nausea and vomiting. If you experience any of these symptoms, let your healthcare team know. They might ask you to stop taking oxymorphone and consider other options.
Low blood pressure
Oxymorphone can cause extremely low blood pressure. For example, your blood pressure might suddenly drop when you stand from a sitting or lying down position. This can lead to dizziness and fainting. To avoid falling, get up slowly if you've been sitting or lying down. Talk to an HCP if dizziness or lightheadedness doesn't go away.
Low adrenal hormone levels
Risk factors: Taking oxymorphone for longer than 1 month
Some people taking opioid medications like oxymorphone have had low adrenal hormone levels. This might be more likely to happen after taking opioids for longer than 1 month.
Tell your healthcare team if you have symptoms of low adrenal hormone levels, such as tiredness, dizziness, weakness, not feeling hungry, nausea, and vomiting. If your adrenal hormone levels are too low, you might need to stop oxymorphone and get treated with corticosteroids.
Seizures
Risk factors: History of seizure conditions
If you've had a seizure in the past, oxymorphone can raise the risk of having seizures more often. Opioids can also raise your risk of seizures in certain situations. Get medical help immediately if you have a seizure while you're taking oxymorphone.
More on Oxymorphone warnings
What are the side effects of Oxymorphone?
Common Side Effects
- Nausea (19%)
- Fever (14%)
- Sleepiness (9%)
- Vomiting (9%)
- Itching (8%)
- Headache (7%)
- Dizziness (7%)
- Nausea (33%)
- Constipation (28%)
- Dizziness (18%)
- Sleepiness (17%)
- Vomiting (16%)
- Itching (15%)
- Headache (12%)
- Sweating (9%)
- Dry mouth (6%)
Other Side Effects
- Constipation
- Confusion
- Dry mouth
- Passing pass
- Feeling anxious
- Diarrhea
- Trouble sleeping
- Tiredness
- Low appetite
- Stomach pain
Serious Side Effects
- Dangerously slow breathing: trouble breathing; bluish-colored lips, fingers, or toes
- Accidentally taking too much (overdose): not responding to sound or touch, slowed breathing, slow heartbeat, extreme sleepiness, cold or clammy skin
- Opioid withdrawal: anxiety, suicidal thoughts, restlessness, irritability, runny nose, yawning, sweating, chills, wide pupils
- Serious allergic reaction: itchy, red rash (hives); shortness of breath; chest tightness; swelling of lips, tongue, throat, face, or eyes
Source:Â DailyMed
More on Oxymorphone side effects
The following side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Less common
Blurred vision
confusion
decreased urination
difficult or labored breathing
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
fast, pounding, racing, or irregular heartbeat or pulse
headache
nervousness
pounding in the ears
rapid breathing
sunken eyes
sweating
swelling of the hands, ankles, or feet
thirst
tightness in the chest
unusual tiredness or weakness
wrinkled skin
Rare
Chest pain or discomfort
chills
cold sweats
confusion about identity, place, and time
decrease in consciousness
deep or fast breathing with dizziness
difficulty in passing urine (dribbling)
difficulty with sleeping
difficulty with swallowing
drowsiness to profound loss of consciousness
hoarseness
irregular, slow, or shallow breathing
irritability
irritation
joint pain, stiffness, or swelling
numbness of the feet, hands, and around the mouth
pale or blue lips, fingernails, or skin
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
redness of the skin
restlessness
seeing, hearing, or feeling things that are not there
severe constipation
severe vomiting
stomach pain
shaking
trouble in holding or releasing urine
unusual drowsiness, dullness, or feeling of sluggishness
Incidence not known
Agitation
darkening of the skin
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals
loss of appetite
mental depression
overactive reflexes
poor coordination
seizures
shivering
talking or acting with excitement you cannot control
twitching
vomiting
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
Cold and clammy skin
constricted, pinpoint, or small pupils (black part of the eye)
decreased awareness or responsiveness
difficult or troubled breathing
irregular, fast, slow, or shallow breathing
low blood pressure or pulse
muscle weakness
pale or blue lips, fingernails, or skin
severe sleepiness or unusual drowsiness
very slow breathing
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Difficulty having a bowel movement
feeling of constant movement of self or surroundings
relaxed and calm
sensation of spinning
sleepiness
Less common
Belching
decreased weight
discouragement
excess air or gas in the stomach or bowels
feeling of warmth
feeling sad or empty
full or bloated feeling
indigestion
lack of appetite
loss of interest or pleasure
passing gas
pressure in the stomach
redness of the face, neck, arms, and occasionally, upper chest
stomach discomfort or upset
swelling of the abdominal or stomach area
tiredness
trouble concentrating
Rare
Blistering, crusting, irritation, itching, or reddening of the skin
cracked, dry, scaly skin
difficulty with thinking or concentrating
disturbed color perception
double vision
false or unusual sense of well-being
feeling jittery
halos around lights
loss of vision
night blindness
nightmares or unusually vivid dreams
overbright appearance of lights
sudden sweating
tunnel vision
welts
Incidence not known
Forgetfulness
loss of memory
problems with memory
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Oxymorphone
Pros
Taken by mouth
Possible option for pain not eased by non-opioid medications
Comes in both short-acting and long-acting tablets
Cons
High risk of misuse, dependence, and addiction
Needs to be taken on an empty stomach
Only available as a tablet
Pharmacist tips for Oxymorphone
Take oxymorphone on an empty stomach at least 1 hour before or 2 hours after eating. Food can affect how oxymorphone is absorbed into your body and put you at higher risk for side effects.
Swallow the oxymorphone extended-release tablet whole with a glass of water. Don't chew, break, crush, or tamper with the tablet because it can cause too much medication to be released all at once in your body, which can put you at risk for serious and life-threatening side effects.
Make sure to tell your care team about all the medications you're taking before and during treatment with oxymorphone. Your care team should review your medication list to make sure your medications are safe to take together. Oxymorphone can have harmful interactions with other medications, like certain antidepressants and benzodiazepines.
You might experience constipation after taking oxymorphone. To lower the risk, drink enough water each day and add more foods with fiber to your diet. Speak to your care team if these lifestyle changes aren't enough to help with this side effect. They can talk with you about other options.
Oxymorphone can make you sleepy and affect your ability to think, react, and focus. Don't drive or do activities where you need to focus until you know how this medication affects you.
Don't drink alcohol while you're taking oxymorphone. Mixing them together can make you very sleepy or dizzy and unable to think clearly. It can also harm your liver.
Don't suddenly stop taking oxymorphone without talking to your prescriber first. Doing so can lead to withdrawal symptoms like muscle aches, chills, and trouble sleeping. If you want to stop oxymorphone, your pain specialist can lower your dose slowly over time to help you stop safely.
People who take an opioid medication are recommended to have naloxone (Narcan) with them at all times. Naloxone is a medication that's used to help reverse the effects of oxymorphone in situations like an accidental overdose. Teach your loved ones about how to give naloxone to you if you can't do it yourself. Be sure to call for emergency help if you need to use naloxone because its effects are temporary.
Keep oxymorphone out of reach from children, pets, or visitors. There are a few drug take-back options to get rid of the medication safely if you don't need to take it anymore. This lessens the risk for accidental overdose and medication misuse.
Frequently asked questions about Oxymorphone
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Oxymorphone dosage forms
Typical dosing for Oxymorphone
Your pain specialist will work with you to find the right dose for your individual needs. It's recommended to take the lowest dose possible for the shortest duration of time to manage your pain.
Immediate-release tablet: The typical starting dose is 10 mg by mouth every 4 to 6 hours as needed for pain on an empty stomach, an hour before or 2 hours after eating.
Extended-release tablet: The typical starting dose is 5 mg by mouth every 12 hours on an empty stomach, an hour before or 2 hours after eating.
Interactions between Oxymorphone and other drugs
More on Oxymorphone interactions
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Nalmefene
- Naltrexone
- Safinamide
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acepromazine
- Alfentanil
- Almotriptan
- Alprazolam
- Alvimopan
- Amifampridine
- Amineptine
- Amitriptyline
- Amitriptylinoxide
- Amobarbital
- Amoxapine
- Amphetamine
- Anileridine
- Aripiprazole
- Asenapine
- Baclofen
- Benperidol
- Benzhydrocodone
- Benzphetamine
- Bromazepam
- Bromopride
- Brompheniramine
- Buprenorphine
- Buspirone
- Butabarbital
- Butorphanol
- Calcium Oxybate
- Cannabidiol
- Carbamazepine
- Carbinoxamine
- Carisoprodol
- Carphenazine
- Cetirizine
- Chloral Hydrate
- Chlordiazepoxide
- Chlorpheniramine
- Chlorpromazine
- Chlorzoxazone
- Cimetidine
- Citalopram
- Clobazam
- Clomipramine
- Clonazepam
- Clopidogrel
- Clorazepate
- Clozapine
- Cocaine
- Codeine
- Cyclobenzaprine
- Desipramine
- Desmopressin
- Desvenlafaxine
- Dexmedetomidine
- Dextroamphetamine
- Dextromethorphan
- Dezocine
- Diazepam
- Dibenzepin
- Dichloralphenazone
- Difenoxin
- Dihydrocodeine
- Diphenhydramine
- Diphenoxylate
- Dolasetron
- Donepezil
- Doxepin
- Doxylamine
- Droperidol
- Duloxetine
- Eletriptan
- Enflurane
- Escitalopram
- Esketamine
- Estazolam
- Eszopiclone
- Ethchlorvynol
- Ethopropazine
- Ethylmorphine
- Fenfluramine
- Fentanyl
- Flibanserin
- Fluoxetine
- Fluphenazine
- Flurazepam
- Fluspirilene
- Fluvoxamine
- Fospropofol
- Frovatriptan
- Furazolidone
- Gabapentin
- Gabapentin Enacarbil
- Granisetron
- Halazepam
- Haloperidol
- Halothane
- Hexobarbital
- Hydrocodone
- Hydromorphone
- Hydroxytryptophan
- Hydroxyzine
- Imipramine
- Iproniazid
- Isocarboxazid
- Isoflurane
- Ketamine
- Ketazolam
- Ketobemidone
- Lasmiditan
- Lemborexant
- Levocetirizine
- Levomilnacipran
- Levorphanol
- Linezolid
- Lisdexamfetamine
- Lithium
- Lofepramine
- Lofexidine
- Lorazepam
- Lorcaserin
- Loxapine
- Magnesium Oxybate
- Meclizine
- Melitracen
- Melperone
- Meperidine
- Mephobarbital
- Meprobamate
- Meptazinol
- Mesoridazine
- Metaxalone
- Methadone
- Methamphetamine
- Methdilazine
- Methocarbamol
- Methohexital
- Methotrimeprazine
- Methylene Blue
- Methylnaltrexone
- Metoclopramide
- Midazolam
- Milnacipran
- Mirtazapine
- Moclobemide
- Molindone
- Moricizine
- Morphine
- Morphine Sulfate Liposome
- Nalbuphine
- Nalorphine
- Naloxone
- Naratriptan
- Nefazodone
- Nialamide
- Nicomorphine
- Nitrazepam
- Nitrous Oxide
- Nortriptyline
- Olanzapine
- Ondansetron
- Opipramol
- Opium
- Opium Alkaloids
- Orphenadrine
- Oxazepam
- Oxycodone
- Ozanimod
- Paliperidone
- Palonosetron
- Papaveretum
- Paregoric
- Paroxetine
- Pentazocine
- Pentobarbital
- Perampanel
- Perazine
- Periciazine
- Perphenazine
- Phenelzine
- Phenobarbital
- Pimozide
- Piperacetazine
- Pipotiazine
- Piritramide
- Potassium Oxybate
- Prazepam
- Pregabalin
- Primidone
- Procarbazine
- Prochlorperazine
- Promazine
- Promethazine
- Propofol
- Protriptyline
- Quazepam
- Quetiapine
- Ramelteon
- Rasagiline
- Remifentanil
- Remimazolam
- Remoxipride
- Rizatriptan
- Samidorphan
- Scopolamine
- Secobarbital
- Selegiline
- Sertindole
- Sertraline
- Sibutramine
- Sodium Oxybate
- St John's Wort
- Sufentanil
- Sulpiride
- Sumatriptan
- Suvorexant
- Temazepam
- Thiethylperazine
- Thiopental
- Thiopropazate
- Thioridazine
- Tianeptine
- Tilidine
- Tizanidine
- Tolonium Chloride
- Topiramate
- Tramadol
- Tranylcypromine
- Trazodone
- Triazolam
- Trifluoperazine
- Trifluperidol
- Triflupromazine
- Trimeprazine
- Trimipramine
- Tryptophan
- Venlafaxine
- Vilazodone
- Vortioxetine
- Zaleplon
- Ziprasidone
- Zolmitriptan
- Zolpidem
- Zopiclone
- Zotepine
How much does Oxymorphone cost?
Oxymorphone contraindications
Severely slowed breathing (respiratory depression)
Severe asthma
Conditions that cause blockage of the stomach passageway
Moderate or severe liver disease
Oxymorphone images
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References
Best studies we foundAmneal Pharmaceuticals of New York LLC. (2024). Oxymorphone hydrochloride tablet, film coated, extended release [package insert]. DailyMed.
Aurolife Pharma, LLC. (2024). Oxymorphone hydrochloride tablet [package insert]. DailyMed.
Centers for Disease Control and Prevention. (2024). About opioid use during pregnancy.
Jansson, L. M., et al. (2019). Neonatal abstinence syndrome. Pediatric Clinics of North America.
National Institute of Diabetes and Digestive and Kidney Diseases. (2018). Adrenal insufficiency & Addison’s disease.
National Institute of Diabetes and Digestive and Kidney Diseases. (2018). Symptoms & Causes of adrenal insufficiency & Addison's disease.
Sloan, P. (2008). Review of oral oxymorphone in the management of pain. Therapeutics and Clinical Risk Management.
U.S. Food and Drug Administration. (2024). Drug disposal: Drug take-back options.
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